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General NPI Number Information
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NPI Number | 1699710236
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Entity Type | Organization
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Legal Business Name | SOUTH SHORE SURGICAL SPECIALISTS, INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 780 MAIN ST SUITE 2A
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-1622
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Country | US
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Telephone | 781-335-4815
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Fax | 781-337-9654
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Provider Business Mailing Address
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Address Line | 780 MAIN ST SUITE 2A
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City | SOUTH WEYMOUTH
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State | MA
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Zip | 02190-1622
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Country | US
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Telephone | 781-335-4815
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Fax | 781-337-9654
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | TRACEY WESSEN
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Credential |
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Telephone | 781-413-2114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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